Medex Primary Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME54477 Issued in FL

Legal business name

MEDEX PRIMARY CARE

Practice address

6500 Crill Ave
BLDG 3 Ste 1
Palatka, FL 32177-9230

Phone

(386) 326-0575

Fax

(386) 326-0571

NPI assigned

Dec 23, 2011

Last updated

Dec 23, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lynn H. Dennis

Title

Office Administrator

Phone

(386) 326-0575

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324598400000",
    "number": "1174892830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE",
            "address_2": "BUILDING 3 SUTE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779230",
            "telephone_number": "386-326-0575",
            "fax_number": "386-326-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE",
            "address_2": "BLDG 3 STE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779230",
            "telephone_number": "386-326-0575",
            "fax_number": "386-326-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEX PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "386-326-0575",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME54477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann McKinley, COTA
• Venus Mone' McRae, RN
• Evan McVicker
• Med Ex
• Medex Medical Express of Palatka LLC
• Melvin M. Seek, MD, PA (North Florida Kidney Care)
• Meridian Behavioral Healthcare, Inc.
• MH Health Care Services, PC
• Sherry D. Michael, LPN
• Miguel Dejuk, PC

• Primary Care Clinic/Center in Palatka, FL
• Providers in Palatka, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.